Nursing has been identified as a shortage occupation in the United States and therefore nurses are exempt from the requirement of obtaining approval by the U.S. Department of Labor of a labor certification application. This significantly reduces the time that it takes nurses to negotiate U.S. Citizenship & Immigration Services (USCIS) processing of permanent residence petitions. However, U.S. immigration law requires that nurses who are applying for permanent residence obtain certification by the Commission on Graduates of Foreign Nursing Schools (CGFNS) that their education, training and competence in oral and written English are roughly comparable to U.S. standards. This certification is referred to as VisaScreen. In addition to obtaining VisaScreen certification, nurses applying for permanent residence must also obtain a full and unrestricted nursing license issued by the state in which they intend to practice, or provide evidence that they have passed the NCLEX-RN exam but have not been issued a license because they do not yet have a social security number.

Nurses who are applying for nonimmigrant visas are currently not required to obtain VisaScreen certification. However, this automatic waiver is set to sunset in July 2004.